Anxiety and Quality of Life Outcomes After Coronary Artery Bypass Graft Surgery - A Prospective Cohort Study.

Improvements in physical and adaptive psychosocial challenges after Coronary artery bypass grafting (CABG) is unclear to what extent these outcomes impact patients' health-related quality of life. This study was to determine the quality of life among patients 3 months after CABG surgery. More specifically, the study examines the contribution of a set of variables on the quality of life. A prospective cohort study was performed over 3 months among 219 adult patients prepared for elective Coronary Artery Bypass Grafting. The data on the baseline measurements Short Form-36 to measure self-reported health-related quality of life and the state-trait anxiety inventory scale to assess anxiety were collected two days before and three months after CABG surgery. The Pearson correlation coefficient was adopted to examine the relationship between confounding, predictor, and dependent variables. Shapiro-Wilk test tested the normality of the distribution of numerical variables. A 2-tailed level of P-value < 0.05 was set to be statistically significant for all analyses. Mean preoperative postoperative physical and mental component score was 34.57 ± 9.6, 43.53 ± 7 and 54.87 ± 1.19, 51.65 ± 9.67, respectively, indicating poor quality of life. Preoperative anxiety uniquely explained with the variation 32.1% and 29.9% and it significantly predicts postoperative physical health quality of life as (ß = .535, t = 8.433, P < 0.001) and postoperative mental health quality of life as (ß = .475, t = 7.147, P < 0.001) respectively. Significant improvement in physical health over the 3 months was confirmed, but mental health-related quality of life is unconvincing with the substantial contribution of anxiety.

Working experiences of nurses during the novel coronavirus outbreak: A qualitative study explaining challenges of clinical nursing practice.

AIM: To explore the clinical working experiences of Saudi nurses during the novel Coronavirus outbreak, identify the challenges and determine how these challenges affect their nursing practice. BACKGROUND: From the current experience of working during the novel Coronavirus outbreak, it is statistically significant to identify the challenges that nurses in Saudi Arabia face in their clinical practice and determine how these challenges affected their practice. DESIGNS: A qualitative descriptive study. METHODS: An in-depth interview with eight Registered Nurses in Saudi Arabia who worked in areas where the novel Coronavirus patients are treated were conducted between 10 and 23 April. RESULTS: The following eight major themes were identified from this study: physical exhaustion, fear of infection, providing care with uncertainty, uncomfortable use of personal protective equipment, missed nursing care, prolonged procedures, lack of guidance during the outbreak and lack of managerial support. CONCLUSION: The results suggest that nurses' leaders should take active roles in empowering nursing staff. The absence of direct monitoring for nursing performance during their practice compromises patient safety and jeopardises the quality of care through missed nursing care. This study also revealed that nurses who worked during the outbreak need psychological support that can enhance their emotional resilience.

Predictors of nursing students' intention to receive COVID-19 vaccination: A multi-university study in Saudi Arabia.

AIMS: This study examined the predictors of student nurses' intention to vaccinate against COVID-19. We measured the nursing students' risk perceptions, anxiety, fears and beliefs on COVID-19 vaccine; attitudes towards it and vaccine literacy (VL). DESIGN: This study is a multi-university study utilizing the quantitative, cross-sectional and predictive approach. METHODS: Using convenience sampling (n = 1170), we surveyed 10 Saudi universities from November 26, 2020, to December 31, 2020. Forward stepwise multinomial logistic regression was performed in identifying the factors predicting student nurses' intention to vaccinate against COVID-19. RESULTS: The overall mean in the risk perception, anxiety and fear was 9.59 (SD = 2.82, possible range = 1-15), 3.95 (SD = 4.77, possible range = 0-20) and 18.17 (SD = 6.65, possible range = 7-35) respectively. They also reported a mean of 29.90 (SD = 6.56, possible range = 8-40) on COVID-19 belief. COVID-19 positive and negative attitudes mean score was 3.64 (SD = 0.92) and 2.72 (SD = 0.90) in a 1-4 range of scores respectively. The functional and interactive-critical COVID-19 VL of the students were at moderate levels. More than half of the respondents (55.9%) intended to be vaccinated against COVID-19, 17.6% did not intend to do so and 26.5% were unsure. High-risk perceptions, low levels of COVID-19 anxiety, positive beliefs and attitudes towards COVID-19 vaccine, and high levels of interactive-critical COVID-19 VL were significant predictors of student nurses' intentions to vaccinate against COVID-19. CONCLUSION: Policymakers could consider the factors identified in this study and why the students did not intend to receive the vaccine in planning a nationwide vaccination program. The colleges of nursing could also utilize the findings in developing educational programs that aim to improve VL and beliefs and attitudes towards COVID-19 vaccine.

COVID-19 crisis: Influence of eHealth literacy on mental health promotion among Saudi nursing students.

OBJECTIVE: This study aims to determine the influence of eHealth literacy on mental health promotion among Saudi nursing students. METHOD: This cross-sectional study was conducted from 19 April to 21 May 2020. A total of 468 nursing students responded to the self-administered online survey. Two instruments, namely, the eHealth Literacy Scale and the Positive Mental Health Scale, were used. Statistical tools such as frequency, percentage, mean, and standard deviation were used for the descriptive analysis. Multiple regression analysis was employed to analyse the relationship between eHealth literacy, health promotion, and its predictors. RESULTS: The results showed that 30.3% of nursing students were dissatisfied with their general health. Students perceived high self-assessed eHealth literacy and positive mental health. Students in the 4th year had lower scores than those of students in the 2nd year. Nursing students perceived that the quarantine and public social distancing lowered their mental health scores. Finally, the eHealth literacy mean scores resulted in a 0.21-point increase in the positive mental health scores. CONCLUSION: The finding of the study shows that the eHealth literacy positively influnce the mental health status of Saudi Nursing students.

Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has seriously impacted various aspects of the society on a global scale. Schools and universities provide rich resources for adolescents and young adults to develop significant coping mechanisms. AIM: This study assessed the perceptions of risk, fear, mental health status, and coping strategies among Saudi student nurses amid the COVID-19 pandemic. METHODS: Using an online survey, the mental health of the students was assessed by the Depression, Anxiety and Stress Scale short form version, whereas the coping was assessed by the Brief-Coping Orientation of Problem Experienced scale. RESULTS: The students had modest risk perception and fear of contracting COVID-19. "Religion" was reported as the most frequently used coping strategy. Approximately 43.3%, 37.2%, and 30.9% of the respondents manifested some degree of depression, anxiety, and stress, respectively. Poor COVID-19 knowledge, perceived seriousness of COVID-19 in Saudi Arabia, perceived risk of COVID-19 infection, and the use of some coping strategies were predictors of fear. Knowing someone infected with COVID-19, fear, and several coping strategies predicted students' mental health. CONCLUSION: This study provides data that can be used to create educational and health policies that focus on the mental health of university students, specifically nursing students.

Sharp injuries and their relationship with stress among nurses working in acute care settings.

BACKGROUND: Sharp injuries are common reasons for the transmission of blood-borne diseases in acute care settings. Fear of sharp injuries and their consequences can expose nurses to high levels of stress (sharp injuries stress). AIM: To examine the occurrence of sharp injuries and to assess their relationship with stress among nurses working in acute care settings. DESIGN: This was a cross-sectional study. METHODS: A total of 150 nurses working in 10 acute care settings in two selected hospitals in Alexandria, Egypt, were selected as the population of this study. Data on the occurrence of sharp injuries were collected using a sharp injuries circumstances questionnaire (including questions regarding number, instrument and reasons/procedures that caused sharp injuries, etc.), and two scales were used to measure sharp injuries stress (the Impact of Event Scale-Revised and the Post-Traumatic Stress Syndrome Questions Inventory). RESULTS: More than 13% of nurses experienced sharp injuries, and 25% of injuries were caused by contaminated instruments. Sharp injuries stress scores were high in nurses, with 65% of nurses experiencing sharp injuries and 30.8% of nurses who did not experience sharp injuries having high Impact of Event Scale-Revised scores. In addition, 45% of nurses who experienced sharp injuries and 15.39% of nurses who did not experience sharp injuries had high Post-Traumatic Stress Syndrome Questions Inventory (PTSSQI) scores. There was a significant relationship between the occurrence of sharp injuries and stress scales at P < .05. CONCLUSIONS: Nurses are exposed to sharp injuries, leading to sharp injury stress pre- and post-occurrence of injuries. Sharp injuries stress can make nurses prone to Post-Traumatic Stress Syndrome (PTSS). RELEVANCE TO CLINICAL PRACTICE: Factors that lead to the occurrence of sharp injuries and sharp injuries stress should be investigated, and a psychological rehabilitation unit should be instituted to help nurses working in acute care settings deal with the sharp injuries-related stressors they are facing.

Nursing Students' Perceptions, Knowledge, and Preventive Behaviors Toward COVID-19: A Multi-University Study.

Background: Knowledge, perception, and preventive behavior should be considered in the planning of effective educational interventions for the coronavirus disease of 2019 (COVID-19) pandemic and in increasing awareness about the health risks brought about by this disease. This research aimed to assess knowledge, perceptions, and preventive behavior toward the COVID-19 infection among student nurses. Methods: The study has quantitative, descriptive, and cross-sectional design. A convenience sample of 1,226 student nurses from seven universities in Saudi Arabia was surveyed from March 22 to April 4, 2020. A four-part online survey on demographic characteristics, perceptions, knowledge, and preventive behavior of Saudi student nurses was carried out. Results: Nearly all students were aware of the outbreak (99.2%), and most of them received information on COVID-19 primarily from social media (71.0%). Over three-fourths of the students were confident that the government (89.1%) and Ministry of Health (MOH) (86.5%) were doing a good job responding to the COVID-19 outbreak in the country. The overall average score in the knowledge questionnaire was 9.85 (SD = 1.62, range = 0-12), which is equivalent to 82.1%. The majority of the students always performed most of the preventive behavior identified in the survey, except "washing hands with soap and water for at least 20 s after blowing my nose, coughing, or sneezing" (39.2%) and "daily cleaning and disinfecting frequently touched surfaces" (41.6%). Being female, being in the fourth year, and gaining good perceived knowledge were associated with high actual COVID-19 knowledge. University, gender, age, academic level, and perceived COVID-19 knowledge were the associated factors. Conclusions: The findings of this study have provided baseline information on the current state of Saudi nursing students' perceptions, knowledge, and preventive behavior toward COVID-19 as the crisis is happening. The findings revealed some areas that should be focused on by nursing education, as well as health agencies, to ensure that the students have adequate knowledge and correct preventive behavior.

Determinants of breast cancer in Saudi women from Makkah region: a case-control study (breast cancer risk factors among Saudi women).

BACKGROUND: There are various factors that play a major role in influencing the overall health conditions of women diagnosed with breast cancer. The population of women in Makkah region are diverse, therefore it is significant to highlight the possible determinants of breast cancer in this population. This is a case-control study that assessed determinants of breast cancer including socioeconomic factors, health-related characteristics, menstrual histories and breastfeeding among postmenopausal women in Makkah region in Saudi Arabia. METHODS: A total of 432 female participants (214 cases and 218 controls) were recruited for this study. A validated questionnaire was completed by trained dietitians at King Abdullah Medical City Hospital in the Makkah region of Saudi Arabia. RESULTS: Results displayed that determinants of breast cancer were associated significantly (P < 0.05) with unemployment, large family size, lack of knowledge and awareness about breast cancer, obesity, sedentary lifestyle, smoking, starting menarche at an early age, as well as hormonal and non-hormonal contraceptive use. There was no effect of diabetes, hypertension, hyperlipidemia, and duration of breastfeeding on the incidence of breast cancer. CONCLUSION: In summary, the results of this study accentuate the possible effect of socioeconomic factors, health-related characteristics and menstrual history on the incidence of breast cancer in postmenopausal women in the Makkah region. Education programs should be applied to increase breast cancer awareness and possibly decrease its incidence.

Assessment of nursing students perceptions of their training hospital's infection prevention climate: A multi-university study in Saudi Arabia.

BACKGROUND: The risk of acquiring and spreading infection must be minimized in nursing students because they are exposed to healthcare-associated infections during clinical training. To achieve this goal, students should be knowledgeable and competent in infection control practice before proceeding to their training hospitals. OBJECTIVES: This study assessed the nursing students' perception of the infection prevention climate in training hospitals in Saudi Arabia. It also examined the predictors of the students' perceptions. DESIGN: A quantitative, cross-sectional design was used. METHODS: This investigation was part of a large study conducted in six Saudi universities. A total of 829 Saudi nursing students were included in this study. Data were collected using the Leading Culture of Quality in Infection Prevention scale and analyzed using descriptive and inferential statistics. Ethical approval was obtained from the King Saud University, and permission was given by the administration of each participating university. RESULTS: The overall perception of nursing students indicated a modest infection prevention climate. Prioritization of quality and improvement orientation was rated as the highest dimensions, whereas psychological safety and supportive environment were the lowest. The nursing students in University F had the poorest perceptions among the six universities. The predictors of nursing student perception of their training hospitals' infection prevention climates were the university where they studied, their age, and participation in infection prevention seminars. CONCLUSIONS: This article describes nursing students' perception of the infection prevention climate of their training hospitals in Saudi Arabia. Results may provide a unique theoretical underpinning on the perception and factors that effect an infection prevention climate. Thereby, previous knowledge and literature may be expanded. Results can be used as a guide in establishing clinical policies in efforts toward improving the infection prevention climate.

A multi-university assessment of patient safety competence during clinical training among baccalaureate nursing students: A cross-sectional study.

AIMS AND OBJECTIVES: To assess the perceived patient safety competence during clinical training of Saudi nursing students. BACKGROUND: Ensuring safety in healthcare settings requires improvements in the educational and clinical practice of professionals. Experts stressed that shared patient safety culture must be of primary importance; they also emphasised the resolute need for theoretically driven research approaches for patient safety competence in healthcare organisations and educational institutions. DESIGN: Descriptive, cross-sectional design. METHODS: This study was conducted in six government universities in Saudi Arabia. A sample of 829 nursing students was surveyed using the health professional education in patient safety survey. Descriptive and inferential statistics were used to analyse the data. The study adhered to the STROBE guideline for cross-sectional studies (See Supporting Information Appendix S1). RESULTS: The percentage of agreement on the items of the health professional education in patient safety survey ranged from 61.5%-76.5%. The dimension "understanding human and environmental factors" received the highest perceived competence, whereas the dimension "working in teams" received the lowest competence. Significant differences in students' patient safety competence from different universities were reported. Male students perceived their competence in "working in teams" higher than the female students. Students in their internship year had significantly higher levels of competence in all the six dimensions of the health professional education in patient safety survey than students in the third- and fourth-year levels. CONCLUSIONS: Saudi nursing students have positive perceptions towards their patient safety competencies. Significant differences were found in the patient safety competence of nursing students between universities, gender and year of study. RELEVANCE TO CLINICAL PRACTICE: The results provide valuable insights and guidance for improving the patient safety competence of nursing students. The findings can be used to guide the creation of policies and interventions that may ensure the continuous development of patient safety competence of nursing students as they navigate the clinical area.

The Combined Effect of Vitamin D Deficiency and Hyperparathyroidism on Postural Stability among Healthy Adult Males.

BACKGROUND AND OBJECTIVE: Vitamin D has been shown to improve muscle strength and bone health; consequently, be important for maintaining good balance. Possible risk factors related to postural stability in young adults still underdetermined. However, this study was designed to determine the effect of vitamin D status on postural stability. MATERIALS AND METHODS: A cross-sectional study of 704 healthy young adult males were enrolled in this study. Dynamic balance was measured as overall stability index (OSI) using biodex balance system (BBS). Vitamin D deficiency was defined when its serum level <20 ng mL-1. The effect size was measured for vitamin D, parathyroid hormone (PTH) and the interaction between vitamin D and PTH (VTD*PTH) with respect to the OSI values. Correlations between variables were examined according to the beta standardised coefficient (ß) and the effect size was measured using the partial eta-squared (η2) test. RESULTS: About 95, 3.8 and 1.2% of individuals had deficient, insufficient and normal vitamin D levels, respectively. Vitamin D had no significant effect to OSI, but PTH exhibited a significant correlation with OSI (adjusted ß = 0.095, p = 0.038). A significant effect size was observed between OSI and PTH (adjusted partial η2 = 0.012, p = 0.038) and between OSI and VTD*PTH (adjusted partial η2 = 0.034, p<0.001). CONCLUSION: A significant interaction of vitamin D deficiency and high PTH on postural stability is detected among healthy adult males.

Compliance with standard precautions during clinical training of nursing students in Saudi Arabia: A multi-university study.

INTRODUCTION: Nursing students are susceptible to healthcare-associated infections because of their direct patient interactions during their clinical training. Hence, compliance with standard precautions (SPs) is paramount during their clinical exposure and training. This study investigated the compliance with SPs and its predictors among Saudi nursing students from six universities. METHODOLOGY: This descriptive, cross-sectional study was conducted in six government universities in Saudi Arabia. A convenience sample of 829 Bachelor of Science in Nursing (BSN) students was surveyed using the Compliance with Standard Precautions Scale. Descriptive and inferential statistics were carried out to analyze the data. RESULTS: The overall compliance rate of the respondents was 60.1% with a mean score of 12.02 (SD = 4.50). The students reported highest compliance on covering the mouth and nose when wearing a mask, while the lowest compliance was on disposing sharps box before it is full. The university, academic year level, and attendance to infection prevention and control training or seminar in the last six months were identified as significant predictors of the students' compliance with SPs. CONCLUSIONS: The findings provide valuable insights and guidance for improving the practice of SPs among future nurses, which could result in the reduction of infection exposure and its transmission rates among future nurses in clinical settings.